EP3506894B1 - Macrophages/microglies dans la neuro-inflammation associée aux maladies neurodégénératives - Google Patents

Macrophages/microglies dans la neuro-inflammation associée aux maladies neurodégénératives Download PDF

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EP3506894B1
EP3506894B1 EP17847576.0A EP17847576A EP3506894B1 EP 3506894 B1 EP3506894 B1 EP 3506894B1 EP 17847576 A EP17847576 A EP 17847576A EP 3506894 B1 EP3506894 B1 EP 3506894B1
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day
compound
cromolyn
als
cells
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EP3506894C0 (fr
EP3506894A4 (fr
EP3506894A1 (fr
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David R. Elmaleh
Rudolph E. Tanzi
Timothy M. Shoup
Ana GRICLUC
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General Hospital Corp
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General Hospital Corp
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/35—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom
    • A61K31/352—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom condensed with carbocyclic rings, e.g. methantheline 
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/425—Thiazoles
    • A61K31/428—Thiazoles condensed with carbocyclic rings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7088—Compounds having three or more nucleosides or nucleotides
    • A61K31/7105—Natural ribonucleic acids, i.e. containing only riboses attached to adenine, guanine, cytosine or uracil and having 3'-5' phosphodiester links
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/007—Pulmonary tract; Aromatherapy
    • A61K9/0073—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/14—Drugs for disorders of the nervous system for treating abnormal movements, e.g. chorea, dyskinesia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00—Drugs for disorders of the cardiovascular system
    • A61P9/10—Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D311/00—Heterocyclic compounds containing six-membered rings having one oxygen atom as the only hetero atom, condensed with other rings
    • C07D311/02—Heterocyclic compounds containing six-membered rings having one oxygen atom as the only hetero atom, condensed with other rings ortho- or peri-condensed with carbocyclic rings or ring systems
    • C07D311/04—Benzo[b]pyrans, not hydrogenated in the carbocyclic ring
    • C07D311/22—Benzo[b]pyrans, not hydrogenated in the carbocyclic ring with oxygen or sulfur atoms directly attached in position 4
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D311/00—Heterocyclic compounds containing six-membered rings having one oxygen atom as the only hetero atom, condensed with other rings
    • C07D311/02—Heterocyclic compounds containing six-membered rings having one oxygen atom as the only hetero atom, condensed with other rings ortho- or peri-condensed with carbocyclic rings or ring systems
    • C07D311/04—Benzo[b]pyrans, not hydrogenated in the carbocyclic ring
    • C07D311/22—Benzo[b]pyrans, not hydrogenated in the carbocyclic ring with oxygen or sulfur atoms directly attached in position 4
    • C07D311/24—Benzo[b]pyrans, not hydrogenated in the carbocyclic ring with oxygen or sulfur atoms directly attached in position 4 with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals, directly attached in position 2

Definitions

  • a ⁇ amyloid- ⁇
  • M1 classical activation
  • M2a alternative activation
  • M2b type II alternative activation
  • M2c acquired deactivation
  • microglia While resident microglial cells surrounding A ⁇ plaques are not as efficacious in degrading A ⁇ as newly infiltrated macrophages or monocytes (See, Thériault, et al., 2015; Varnum, et al., "The classification of microglial activation phenotypes on neurodegeneration and regeneration in Alzheimer's disease brain,” Arch. Immunol. Ther. Exp. (Warsz), 2012, 60(4):251-66 ), it has been shown that microglia are indeed capable of internalizing fibrillar and soluble A ⁇ , but are unable to process these peptides. (See Chung, et al., "Uptake, degradation, and release of fibrillar and soluble forms of Alzheimer's amyloid beta-peptide by microglial cells," J. Biol. Chem., 1999, 274:32301-8 ).
  • microglia undergo a switch from an M2- to an M1-skewed activation phenotype during aging.
  • M2- a switch from an M2- to an M1-skewed activation phenotype during aging.
  • Varnum, et al., 2012 Gratchev, et al., "Mphi1 and Mphi2 can be re-polarized by Th2 or Th1 cytokines, respectively, and respond to exogenous danger signals”
  • Immunobiology, 2006, 211(6-8):473-486 Colton, et al., "Expression profiles for macrophage alternative activation genes in AD and in mouse models of AD," J. Neuroinflammation, 2006, 3:27 ).
  • microglia are activated by extracellularly deposited A ⁇ peptide ( Lotz, et al., "Amyloid beta peptide 1-40 enhances the action of Toll-like receptor-2 and -4 agonists but antagonizes Toll-like receptor-9-induced inflammation in primary mouse microglial cell cultures," J. Neurochem., 2005, 94:289-298 ; Reed-Geaghan, et al., "CD14 and toll-like receptors 2 and 4 are required for fibrillar A ⁇ -stimulated microglial activation," J. Neurosci., 2009, 29: 11982- 11992 ).
  • M1 activated microglia can produce reactive oxygen species and result in increased production of pro-inflammatory cytokines such as TNF ⁇ and interleukin (IL)-1 ⁇ .
  • the M1-type response of microglial cells has been shown to lower amyloid load but exacerbate neurofibrillary tangle pathology.
  • Shaftel et al. Shaftel, et al., "Sustained hippocampal IL- 1 ⁇ overexpression mediates chronic neuroinflammation and ameliorates Alzheimer plaque pathology," J. Clin. Invest., 2007, 117(6):1595-604 ) have shown that IL-1 ⁇ expression may underlie a beneficial neuroinflammatory response in AD, and that IL-1 ⁇ overexpression in the hippocampus of APP/PS 1 transgenic mice results in decreased amyloid burden.
  • the authors suggest that IL-1 ⁇ -mediated activation of microglia is the mechanism for the reductions in amyloid deposition.
  • Macrophage M2 activation is associated with mediators that are known to contribute to the anti-inflammatory actions and reorganization of extracellular matrix ( Zhu, et al., "Acidic mammalian chitinase in asthmatic Th2 inflammation and IL-13 pathway activation", Science, 2004, 304(5677):1678-82 ; Walker, et al., 2015; Wilcock, et al., 2012).
  • Microglia with M2a phenotypes have increased phagocytosis and produce growth factors such as insulin-like growth factor-1 and anti-inflammatory cytokines such as IL-10.
  • M2a Stimulation of macrophages by IL-4 and/or IL-13 results in an M2a state, sometimes called a wound-healing macrophage ( Edwards, et al., "Biochemical and functional characterization of three activated macrophage populations," J. Leukoc Biol., 2006, 80(6):1298-307 ) and it is generally characterized by low production of pro-inflammatory cytokines (IL-1, TNF and IL-6).
  • IL-1, TNF and IL-6 pro-inflammatory cytokines
  • the M2a responses are primarily observed in allergic responses, extracellular matrix deposition, and remodeling.
  • M2b macrophages are unique in that they express high levels of pro-inflammatory cytokines, characteristic of M1 activation, but also express high levels of the anti-inflammatory cytokine IL-10. (See, Moser DM., "The many faces of macrophage activation,” J. Leukoc Biol., 2003, 73(2):209-12 ).
  • M2c macrophage state is stimulated by IL-10 and is sometimes referred to as a regulatory macrophage.
  • M2c macrophages have anti-inflammatory activity that plays a role in the phagocytosis of cellular debris without the classical pro-inflammatory response (See, Moser DM., 2003). These cells express TGF ⁇ and high IL-10 as well as matrix proteins. (See, Mantovani, et al., "The chemokine system in diverse forms of macrophage activation and polarization," Trends Immunol., 2004, 25:677-686 ; Wilcock, et al., 2012). Plunkett et al.
  • microglia activated by extracellularly deposited A ⁇ protect neurons by triggering anti-inflammatory/neurotrophic M2 activation and by clearing A ⁇ via phagocytosis. This is a potential avenue for new therapeutic targets.
  • Yamamoto, et al. "Interferon- gamma and tumor necrosis factor-alpha regulate amyloid-beta plaque deposition and beta- secretase expression in Swedish mutant APP transgenic mice," Am. J.
  • Pathol. 2007, 170:680-692 ; Yamamoto, et al., "Cytokine-mediated inhibition of fibrillar amyloid-beta peptide degradation by human mononuclear phagocytes," J. Immunol., 2008, 181:3877-3886 ).
  • Mantovani et al. (Mantovani, et al., 2004) studied the effect of IL-4 as an important modulator of M2a microglial activation. It has been shown that gene delivery of IL-4 into APP+PS1 mice partially suppressed glial accumulation in the hippocampus, directly enhanced neurogenesis, restored impaired spatial learning, and also reduced A ⁇ deposition (Kiyota, et al., 2010).
  • Yamamoto et al. (Yamamoto, et al., 2007, 2008) examined macrophage-mediated A ⁇ degradation using pro- and anti-inflammatory cytokines in primary cultured human monocyte-derived macrophages (MDM) and microglia. These studies showed that anti-inflammatory and regulatory cytokines lead to an increase in M2a or M2c activation and enhanced A ⁇ clearance. Kiyota et al. (Kiyota et al., 2011) have shown sustained expression of IL-4 reduced astro/microgliosis, amyloid- ⁇ peptide (A ⁇ ) oligomerization and deposition, and enhanced neurogenesis.
  • MDM monocyte-derived macrophages
  • the invention encompasses methods of treating a neuron inflammation condition comprising administering a therapeutically effective amount to a patient in need thereof of a compound having the following formula: (F-ET-Cromolyn) wherein the neuron inflammation condition is selection from amyotrophic lateral sclerosis (ALS), Huntington's Disease, Parkinson's Disease (PD), ischemic stroke, and a condition associated with prion disease.
  • ALS amyotrophic lateral sclerosis
  • PD Parkinson's Disease
  • ischemic stroke ischemic stroke
  • a condition associated with prion disease a condition associated with prion disease.
  • the method uses the following compounds: Cromolyn Disodium; F-Cromolyn Diacid; ET-Cromolyn; Triol-Cromolyn; F-Triol-Cromolyn; Ac-Triol-Cromolyn; POM-Cromolyn; or
  • the compounds may be administered intraperitoneally (IP) and/or intravenously (IV).
  • IP intraperitoneally
  • IV intravenously
  • the compounds may be administered at a dose between about 1 mg and about 1000 mg per day.
  • the method of administration may be transdermally or by inhalation.
  • the method is a method of treating ALS further comprising co-administering CD4+; siRNA; miRNA that ameliorate ALS; glial morphology modifier; SOD1 control; Riluzole; or another M1; M2 conversion active drug that controls neuroinflammation.
  • the invention encompasses anti-inflammatory compounds to reduce the toxic effect of pro-inflammatory cytokines by converting microglia from a pro-inflammatory M1 state to an M2 state in which the toxic effects are reduced and their phagocytic activity toward amyloidosis, tauopathies and other cytotoxic events is enhanced.
  • the invention also encompasses the use of the compounds to affect therapy early in the disease process.
  • the compounds described herein are the only effective, non-cytokine (e.g. IL-10) compounds exhibiting M1-to-M2 activity.
  • the invention encompasses a compound having the following formula: for use in the treatment of a neuron inflammation condition in a patient in need thereof, wherein the neuron inflammation condition is selected from amyotrophic lateral sclerosis (ALS), Huntington's Disease, Parkinson's disease (PD), ischemic stroke, and a condition associated with prion disease.
  • Certain comparative examples also include 5-[3-(2-carboxy-4-oxochromen-5-yl)oxy-2-hydroxypropoxy]-4-oxochromene-2-carboxylic acid derivatives and isomeric forms.
  • the compounds may be used to treat ALS including, but not limited to, slowing down or halting the progression of the disease.
  • the compounds may be administered in combination with other anti-inflammatory agents to control the spread of the progressive and fatal effect of ALS.
  • the invention encompasses a combination treatment for ALS of M1, M2 conversion active drugs that control neuroinflammation, such as the drugs in the above formulas, with other immune targeting therapies such as CD4+, siRNA, miRNA that ameliorates ALS, glial morphology modifiers, SOD 1 controls, or Riluzole, the only approved drug for ALS.
  • M1, M2 conversion active drugs that control neuroinflammation such as the drugs in the above formulas
  • other immune targeting therapies such as CD4+, siRNA, miRNA that ameliorates ALS, glial morphology modifiers, SOD 1 controls, or Riluzole, the only approved drug for ALS.
  • the compounds will slow down or halt neuron damage for neurons located in the brain stem and/or the spinal cord, neurons, or motor neurons that affect voluntary body muscles.
  • the compounds may be administered using known methods for the administration of drugs, for example, IP, IV, transdermally, by inhalation.
  • the invention relates to methods of treating or slowing down the aggressive progression of a neurological disease, such as AD, Ischemic Stroke, ALS, or Prion, and the compound is administered by infusion or intraperitoneal administration.
  • the invention also provides pharmaceutical compositions comprising one or more compounds described herein in association with a pharmaceutically acceptable carrier.
  • these compositions are in unit dosage forms such as tablets, pills, capsules, powders, granules, sterile parenteral solutions or suspensions, metered aerosol or liquid sprays, drops, ampoules, auto-injector devices or suppositories; for oral, parenteral, intranasal, sublingual or rectal administration, or for administration by inhalation or insufflation.
  • the compounds may be incorporated into transdermal patches designed to deliver the appropriate amount of the drug in a continuous fashion.
  • the principal active ingredient is mixed with a pharmaceutically acceptable carrier, e.g. conventional tableting ingredients such as corn starch, lactose, sucrose, sorbitol, talc, stearic acid, magnesium stearate, dicalcium phosphate or gums, and other pharmaceutical diluents, e.g. water, to form a solid preformulation composition containing a homogeneous mixture.
  • a pharmaceutically acceptable carrier e.g. conventional tableting ingredients such as corn starch, lactose, sucrose, sorbitol, talc, stearic acid, magnesium stearate, dicalcium phosphate or gums, and other pharmaceutical diluents, e.g. water
  • a pharmaceutically acceptable carrier e.g. conventional tableting ingredients such as corn starch, lactose, sucrose, sorbitol, talc, stearic acid, magnesium stearate, dicalcium phosphate or gums, and other pharmaceutical dilu
  • a dry powder composition is micronized for inhalation to the lungs. See for example, U.S. Patent Application publication 2016/0263257 , and in particular regarding the dry powder cromolyn formulations described therein.
  • the dry powder composition further comprises at least one excipient.
  • the at least one excipient comprises Lactose monohydrate and/or Magnesium stearate.
  • the compounds may be administered in doses that treat the particular indication.
  • the dose is specifically tailored to lead to blood, brain, and CSF concentrations that allow the drugs to act as M1-to-M2 modifiers.
  • Such doses may include from about 1 mg to about 1000 mg per day.
  • the dosage of the active agents will generally be dependent upon a number of factors, including the pharmacodynamic characteristics of the compound, mode and route of administration of the compound, the health of the patient being treated, the extent of treatment desired, the nature and kind of concurrent therapy, if any, and the frequency of treatment and the nature of the effect desired.
  • dosage ranges of the compound often range from about 0.001 to about 250 mg/kg body weight per day.
  • a dosage may range from about 0.1 to about 25 mg/kg body weight.
  • some variability in this general dosage range may be required depending on the age and weight of the subject being treated, the intended route of administration, the particular agent being administered, and the like.
  • the determination of dosage ranges and optimal dosages for a particular mammal is also well within the ability of one of ordinary skill in the art having the benefit of the instant disclosure.
  • Dosages for compounds may be as low as 5 ng/d.
  • Dosage ranges for active agents may be from 5 ng/d to 100mg/day. In certain embodiments, dosage ranges for active agents may be from about 5 ng/day to about 10 ng/day, about 15 ng/day, about 20 ng/day, about 25 ng/day, about 30 ng/day, about 35 ng/day, about 40 ng/day, about 45 ng/day, about 50 ng/day, about 60 ng/day, about 70 ng/day, about 80 ng/day, about 90 ng/day, about 100 ng/day, about 200 ng/day, about 300 ng/day, about 400 ng/day, about 500 ng/day, about 600 ng/day, about 700 ng/day, about 800 ng/day, or about 900 ng/day.
  • dosage ranges for compounds may be from about 1 ⁇ g/day to about 2 ⁇ g/day, about 3 ⁇ g/day, about 4 ⁇ g/day, about 5 ⁇ g/day, about 10 ⁇ g/day, about 15 ⁇ g/day, about 20 ⁇ g/day, about 30 ⁇ g/day, about 40 ⁇ g/day, about 50 ⁇ g/day, about 60 ⁇ g/day, about 70 ⁇ g/day, about 80 ⁇ g/day, about 90 ⁇ g/day, about 100 ⁇ g/day, about 200 ⁇ g/day, about 300 ⁇ g/day, about 400 ⁇ g/day about 500 ⁇ g/day, about 600 ⁇ g/day, about 700 ⁇ g/day, about 800 ⁇ g/day, or about 900 ⁇ g/day.
  • dosage ranges for active agents may be from about 1mg/day to about 2 mg/day, about 3 mg/day, about 4 mg/day, about 5 mg/day, about 10 mg/day, about 15 mg/day, about 20 mg/day, about 30 mg/day, about 40 mg/day, about 50 mg/day, about 60 mg/day, about 70 mg/day, about 80 mg/day, about 90 mg/day, about 100 mg/day, about 200 mg/day, about 300 mg/day, about 400 mg/day, about 500 mg/day, about 600 mg/day, about 700 mg/day, about 800 mg/day, or about 900 mg/day.
  • the compounds are administered in pM or nM concentrations. In certain embodiments, the compounds are administered in about 1 pM, about 2 pM, about 3 pM, about 4 pM, about 5 pM, about 6 pM, about 7 pM, about 8 pM, about 9 pM, about 10 pM, about 20 pM, about 30 pM, about 40 pM, about 50 pM, about 60 pM, about 70 pM, about 80 pM, about 90 pM, about 100 pM, about 200 pM, about 300 pM, about 400 pM, about 500 pM, about 600 pM, about 700 pM, about 800 pM, about 900 pM, about 1 nM, about 2 nM, about 3 nM, about 4 nM, about 5 nM, about 6 nM, about 7 nM, about 8 nM, about 9 nM, about 10 nM, about 20 pM,
  • the dosage form is a solid dosage form, and the size of the compound in the dosage form is important.
  • the compound is less than about 3 ⁇ m, less than about 2 ⁇ m, or less than about 1 ⁇ m in diameter.
  • the active agent is about 0.1 ⁇ m to about 3.0 ⁇ m in diameter. In certain embodiments, the active agent is from about 0.5 ⁇ m to about 1.5 ⁇ m in diameter.
  • the active agent is about 0.2 ⁇ m, about 0.3 ⁇ m, about 0.4 ⁇ m, about 0.5 ⁇ m, about 0.6 ⁇ m, about 0.7 ⁇ m, about 0.8 ⁇ m, about 0.9 ⁇ m, about 1.0 ⁇ m, about 1.1 ⁇ m, about 1.2 ⁇ m, about 1.3 ⁇ m, about 1.4 ⁇ m, or about 1.5 ⁇ m in diameter.
  • a formulation intended for oral administration to humans may contain from about 0.1 mg to about 5 g of the active agent (or compound) compounded with an appropriate and convenient carrier material varying from about 5% to about 95% of the total composition.
  • Unit dosages will generally contain between about 0.5 mg to about 1500 mg of the active agent.
  • the dosage may be about: 1 mg, 2 mg, 3 mg, 4 mg, 5 mg, 6 mg, 7 mg, 8 mg, 9 mg, 10 mg, 11 mg, 12 mg, 13 mg, 14 mg, 15 mg, 16 mg, 17 mg, 18 mg, 19 mg, 20 mg, 21 mg, 22 mg, 23 mg, 24 mg 25 mg, 26 mg, 27 mg, 28 mg, 29 mg, 30 mg, 31 mg, 32 mg, 33 mg, 34 mg 35 mg, 36 mg, 37 mg, 38 mg, 39 mg, 40 mg, 41 mg, 42 mg, 43 mg, 44 mg, 45 mg, 46 mg, 47 mg, 48 mg, 49 mg, 50 mg, 55 mg, 60 mg, 65, mg, 70 mg, 75 mg, 80 mg, 85 mg, 90 mg, 95 mg, 100 mg, 200 mg, 300 mg, 400 mg, 500 mg, 600 mg, 800 mg, or 100 mg, etc., up to about 1500 mg of the compound.
  • the invention relates to combination of two active agents.
  • the ratio of the first active agent to the second active agent is about: 200:1, 190:1, 180:1, 170:1, 160:1, 150:1, 140:1, 130:1, 120:1, 110:1, 100:1, 90:1, 80:1, 70:1, 60:1, 50:1, 40:1, 30:1, 20:1, 15:1, 10:1, 9:1, 8:1, 7:1, 6:1, or 5:1. It further may be preferable to have a more equal distribution of pharmaceutical agents.
  • the ratio of the first active agent to the second active agent is about: 4:1, 3:1, 2:1, 1:1, 1:2, 1:3, or 1:4. It may also be advantageous for the pharmaceutical combination to have a relatively large amount of the second component compared to the first component. In certain instances, the ratio of the second active agent to the first active agent is about 200:1, 190:1, 180:1, 170:1, 160:1, 150:1, 140:1, 130:1, 120:1, 110:1, 100:1, 90:1, 80:1, 70:1, 60:1, 50:1, 40:1, 30:1, 20:1, 15:1, 10:1, 9:1, 8:1, 7:1, 6:1, or 5:1.
  • a composition comprising any of the above identified combinations of the first therapeutic agent and second therapeutic agent may be administered in divided doses about 1, 2, 3, 4, 5, 6, or more times per day or in a form that will provide a rate of release effective to attain the desired results.
  • the dosage form may contain both the first and second active agents.
  • the dosage form may be administered one time per day if it contains both the first and second active agents.
  • a formulation intended for oral administration to humans may contain from about 0.1 mg to about 5 g of the first therapeutic agent and about 0.1 to about 5 g of the second therapeutic agent, both of which are compounded with an appropriate and convenient about of carrier material varying from about 5% to about 95% of the total composition.
  • Unit dosages will generally contain between about 0.5 mg to about 1500 mg of the first therapeutic agent and 0.5 mg to 1500 mg of the second therapeutic agent.
  • the dosage may be about: 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, 400 mg, 500 mg, 600 mg, 800 mg, or 100 mg, etc., up to about 1500 mg of the first therapeutic agent.
  • the dosage may be about: 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, 400 mg, 500 mg, 600 mg, 800 mg, or 100 mg, etc., up to about 1500 mg of the second therapeutic agent.
  • Fig. 1B illustrates representative images of localization of amyloid deposits (6E10) and microglia (Iba1) in mice treated with Cromolyn Sodium (3.15mg/kg) or PBS daily for seven days.
  • Fig. 1C illustrates the effect of Cromolyn Sodium on microglial A ⁇ uptake in vitro. Microglial cells were cultured and incubated with 50 nM of synthetic A ⁇ 40 or A ⁇ 42 and 0, 10 nM, 10 ⁇ M or 1 mM of Cromolyn Sodium for 16 hours. After the incubation, the concentrations of A ⁇ x-40 ( Fig.
  • FIG. 2 illustrates representative plaques of all the plaques and the microglial cells surrounding those deposits in Tg-2576 mice of the study.
  • An image analysis looking at the percentage of Iba-1 positive processes colocalizing with the amyloid staining versus the total amount of Iba-1 signal surrounding the plaque demonstrated that there was more Iba-1/Amyloid colocalization when the mice were treated with Cromolyn Sodium as opposed to any other groups. This result correlates with our results in Example 1 and our in vitro data.
  • BV2 microglial cell cultures were treated with cromolyn and/or ibuprofen (10 ⁇ M, 100 ⁇ M, 1 mM) for 16 hours. Afterwards, cells were incubated with soluble A ⁇ 42 and the compounds for 3 hours. After incubation, cells were collected for ELISA analysis.
  • Figure 3 graphically illustrates the results of BV2 microglial cells treated with cromolyn, and with cromolyn and ibuprofen exhibit increased A ⁇ 42 uptake levels relative to BV2 microglia treated with the vehicle.
  • Acetic anhydride (0.5 g, 4.6 mmol) was slowly added to a mixture of 5,5'-[(2-hydroxy-1,3-propanediyl)bis(oxy)]bis[4-oxo-4 H -1-benzopyran-2-ethanol (0.5 g, 1.14 mmol) in pyridine (20 mL) cooled to 0-5°C. The mixture was stirred for 3 hr at 0-5°C and then allowed to warm to room temperature. TLC indicted the reaction was complete. Methylene chloride was added and the mixture was washed with 10% HCl until the aqueous phase was acidic. The methylene chloride layer was dried over anhydrous sodium sulfate and solvent was evaporated.
  • Example 4 A ⁇ aggregation inhibition assay.
  • Synthetic Aa ⁇ 42 in final 5 uM was incubated with 10, 100, 1,000 nM of test compounds for 1 hour.
  • the aggregation was initiated with heparin at 0.5 mg/ml in final concentration.
  • the assay buffer consisted of 125 mM NaCl, 2.5 mM KCl, 1 mM MgCl 2 , 1.25 mM Na 2 H 2 PO 4 , 2 mM CaCl 2 , 25 mM Glucose, and NaHCO 3 to adjust pH to 7.4.
  • the assay buffer was used as a control.
  • the aggregation was measured by intensity of Thioflavin T binding, which was detected by fluorescent excitation/emission at 450 nm/480 nm (Spectra Max M3 plate reader, Molecular Devices) in a kinetic mode. Aggregation was recorded as the kinetics was calculated as Vmax by the plate reader's software.
  • the assay was performed in triplicate and expressed as standard mean ⁇ SD. Blue dotted line indicate the assay buffer control.
  • Figure 4 illustrates the results of the assay.
  • Figure 5 graphically illustrates the results of a one-way of the differences in the A ⁇ levels and the ratios of A ⁇ (42:40).
  • BV2-CD33 WT The effect of compounds in BV2 cells stably expressing full-length human CD33 was assessed to explore whether they reverse CD33-mediated inhibition of A ⁇ uptake ( Griciuc et al., 2013 Neuron 78, 631-643 ).
  • the compound numbers, molecular weight and concentration of the stock solutions are summarized in Table 1.
  • the invention relates to cromolyn derivative C4.
  • Cromolyn derivatives C1-C3 and C5-C8 are not part of the invention.
  • Cromolyn derivatives, C3 and C4 displayed lower solubility in DMSO in comparison to C1, C2, C5, C6, C7 and C8. Therefore, a 25 mM stock solutions for all the compounds except for C3 and C4 were prepared.
  • the stock solutions for C3 and C4 were prepared at 5 mM and 7.5 mM, respectively.
  • C1 is the parent compound - cromolyn disodium.
  • Table 1 Summary of compounds tested in microglial cells Compound Number Compound Name Stock Solution (mM) C1 Cromolyn Disodium 25 C2 F-Cromolyn Diacid 25 C3 ET-Cromolyn 5 C4 F-ET-Cromolyn 7.5 C5 Triol-Cromolyn 25 C6 F-Triol-Cromolyn 25 C7 Ac-Triol-Cromolyn 25 C8 POM-Cromolyn 25
  • naive BV2 cells were treated with DMSO (control) or cromolyn at 500 ⁇ M for 16 hours. Afterwards, cells were washed with PBS and treated with DMSO or cromolyn in the presence of the fluorescently-tagged A ⁇ 42 peptide (400 nM, red) for 2 hours. At the end of the treatment, the cells were washed and labeled them with a plasma membrane dye (green). Using confocal microscopy and the fluorescence signal in the red channel, the levels of intracellular A ⁇ 42 peptide were quantified. All the quantifications were performed by a blind observer with the ImageJ software. Remarkably, cromolyn sodium led to increased uptake of A ⁇ 42 in naive BV2 microglial cells ( Fig. 6A-Fig. 6D ).
  • cromolyn sodium modulates A ⁇ 42 uptake in na ⁇ ve BV2 microglial cells was determined by using the ELISA assay. Additionally, whether cromolyn sodium leads to increased A ⁇ 42 uptake levels in BV2 cells stably expressing full-length human CD33 (BV2-CD33 WT ) was determined. To this purpose, both naive BV2 and BV2-CD33 WT cell lines were treated with DMSO (control) or cromolyn at different concentrations for 16 hours. Then, the cells were washed with PBS and treated with DMSO or cromolyn and soluble untagged A ⁇ 42 peptide (400 nM) for 2 hours. The collected cell lysates were analyzed for A ⁇ 42 uptake levels using the A ⁇ 42-specific ELISA kit from Wako. The ELISA results were normalized to the protein concentration levels that were previously quantified using the BCA assay.
  • naive BV2 or BV2-CD33 WT cells were plated in proliferating media.
  • cells were treated with DMSO (control) or the compounds at different concentrations in proliferating media for 3 hours.
  • C1, C2, C5, C6, C7 and C8 were tested at 10, 50, 100 and 150 ⁇ M, while C3 and C4 were assessed at 5, 25, 50 and 75 ⁇ M due to solubility limit in DMSO.
  • cells were washed with PBS and treated with DMSO or compounds in the presence of the untagged A ⁇ 42 peptide (400 nM) in DMEM media for 2 hours.
  • naive BV2 microglial cells were incubated with DMSO (vehicle) or cromolyn derivatives at different concentrations for 3 hours. The cells were then washed and incubated with DMSO or compounds and soluble untagged A ⁇ 42 for additional 2 hours. Afterwards, the cell media was collected and measured LDH released by the damaged cells to identify the compounds that induce cytolysis. The LDH assay showed that the cromolyn derivative C8 is the only compound showing toxicity when tested at 100 and 150 ⁇ M ( Fig. 8 ). Therefore, 100 and 150 ⁇ M concentrations for C8 were excluded from the A ⁇ 42 uptake assays.
  • Example 8 Modulation of A ⁇ 42 uptake in microglial cells by cromolyn derivatives
  • naive BV2 microglial cells were treated with DMSO (control) or cromolyn derivative compounds at different concentrations for 3 hours. Afterwards, the cells were washed and treated with DMSO or compounds in the presence of untagged A ⁇ 42 peptide for 2 hours. At the end of the treatment, the cell lysates were collected. The analysis for intracellular A ⁇ 42 levels is performed using an A ⁇ 42-specific ELISA kit. The parent compound C1 (cromolyn sodium) led to a modest increase of A ⁇ 42 uptake at 100 and 150 ⁇ M in BV2 cells.
  • the C1 aliquot received with the other cromolyn derivatives displayed lower solubility in DMSO than the C1 aliquot that was sent to us the first time (without the cromolyn derivatives).
  • the compound C6 led to a robust inhibition of A ⁇ 42 uptake in BV2 microglial cells.
  • the cromolyn derivative C4 led to an increased uptake of A ⁇ 42 peptide at 75 ⁇ M in naive BV2 microglial cells ( Fig. 9 ).
  • BV2-CD33 WT cells were treated with DMSO (control) or cromolyn derivatives at different concentrations ranging between 5 and 150 ⁇ M.
  • the cromolyn derivatives C1 and C3-8 were tested.
  • the compound C2 was tested with other cromolyn derivatives in the second set of experiments.
  • Treatment with the compound C4 at 75 ⁇ M resulted in a two-fold increase in A ⁇ 42 uptake in comparison to DMSO treatment and displayed a dose-dependent effect at 50 ⁇ M ( Fig. 10 ).
  • the IC 50 for C4 was 54.7 ⁇ M in BV2-CD33 WT cells.
  • the compound C6 exhibits a dose-dependent effect in mediating inhibition of A ⁇ 42 uptake in BV2-CD33 WT cells when compared to DMSO treatment.

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  1. Composé ayant la formule suivante :
    Figure imgb0038
     destiné à une utilisation dans le traitement d'une inflammation des neurones chez un patient qui en a besoin, dans lequel l'inflammation de neurones est choisie parmi la sclérose latérale amyotrophique (SLA), la maladie de Huntington, la maladie de Parkinson (MP), l'accident ischémique et une affection associée à une maladie à prions
  2. Composé destiné à une utilisation selon la revendication 1, dans lequel lorsque l'inflammation des neurones est une SLA, le composé est administré par voie IP et/ou IV.
  3. Composé destiné à une utilisation selon la revendication 1, dans lequel le composé est administré par voie transdermique ou par inhalation.
  4. Composé destiné à une utilisation selon la revendication 1, dans lequel, lorsque l'inflammation des neurones est une SLA, l'utilisation comprend en outre la co-administration d'un second composé choisi parmi les CD4+ ; le siARN ; les miARN qui améliorent les SLA ; un modificateur de morphologie gliale ; le SOD1 de contrôle ; le riluzole, médicament anti-agrégation et médicament ciblant l'AD.
  5. Composé destiné à une utilisation selon la revendication 1, dans lequel, lorsque l'inflammation de neurones est une SLA, l'utilisation comprend en outre la co-administration d'un second composé choisi parmi un médicament de ciblage d'anticorps qui améliore la SLA et un médicament de ciblage anti-inflammatoire qui améliore la SLA.
  6. Composé destiné à une utilisation selon l'une quelconque des revendications 1 à 3, dans lequel l'utilisation comprend en outre la co-administration d'un second composé choisi parmi un médicament de ciblage qui améliore la neurodégénérescence associée à l'amyloïdose ou aux tauopathies.
  7. Composé destiné à une utilisation selon la revendication 1, dans lequel, lorsque l'inflammation des neurones
    est la MP, l'utilisation comprend en outre la co-administration d'un second composé choisi parmi un médicament ciblant l'alpha-synucléine qui améliore la MP et un médicament de ciblage de Parkinson qui améliore la MP.
  8. Composition pharmaceutique destinée à une utilisation dans le traitement d'une inflammation des neurones chez un patient qui en a besoin, dans laquelle l'inflammation de neurones est choisie parmi la sclérose latérale amyotrophique (SLA), la maladie de Huntington, la maladie de Parkinson (MP), l'accident ischémique et une affection associée à une maladie à prions ; et dans laquelle la composition pharmaceutique comprend un support pharmaceutiquement acceptable et
    Figure imgb0039
  9. Composition pharmaceutique destinée à une utilisation selon la revendication 8, dans laquelle la composition pharmaceutique est sous la forme d'un comprimé, d'une pilule, d'une capsule, d'une poudre, d'un granulé, d'une solution ou d'une suspension parentérale stérile, d'un aérosol dosé ou à pulvérisation liquide, d'une goutte, d'une ampoule, d'un dispositif d'auto-injection ou d'un suppositoire.
  10. Composition pharmaceutique destinée à une utilisation selon la revendication 8, dans laquelle la composition pharmaceutique est une composition solide.
  11. Composition pharmaceutique destinée à une utilisation selon la revendication 10, dans laquelle la composition solide est une poudre ou un comprimé.
  12. Composition pharmaceutique destinée à une utilisation selon la revendication 8 ou la revendication 9, dans laquelle la composition pharmaceutique est administrée par voie orale, parentérale, intranasale, sublinguale, rectale, par inhalation, ou par insufflation.
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